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目的:系统评价精索扭转的诊断及处理方法。方法:计算机检索Cochrane图书馆、PubMed、维普资讯、CNKI,查找有关精索扭转的随机对照研究,检索时限均为1990~2012年,研究者对文献质量进行严格评价和资料提取,采用盲法分析。结果:共纳入27篇文献,3 541例患者纳入研究。结果表明:多普勒彩超在诊断阴囊急症明显优于常规超声,成为阴囊急症的首选影像学诊断方法;对任何年龄段的急性阴囊疼痛的患者均应行手术探查,没有足够的证据支持单侧精索扭转行对侧睾丸固定;精索扭转对于患侧睾丸生育功能的影响会随着患者年龄的增长而增加,对于健侧睾丸的影响尚存在争议。结论:对于有阴囊症状的患者应及时行阴囊多普勒彩超筛查,对于已确认精索扭转患者及阴囊急症患者应立即行阴囊手术探查,根据具体情况以决定是否行双侧睾丸固定术,对患者生育功能应加强随访。
Objective: To systematically evaluate the diagnosis and treatment of sphincter of torsion. Methods: The Cochrane Library, PubMed, VIP Information and CNKI were searched by computer. The randomized controlled study on spermatic cord twisting was searched from 1990 to 2012. The researchers conducted rigorous evaluation and data extraction on the quality of the literature. Blinded analysis . RESULTS: A total of 27 articles were included and 3 541 patients were enrolled in the study. The results show that: Doppler ultrasound in the diagnosis of scrotal emergency was significantly better than conventional ultrasound, scrotal emergency imaging as the preferred method of diagnosis; for patients of any age of acute scrotal pain should be surgical exploration, there is not enough evidence to support unilateral Spermatic cord twisting contralateral testicular fixation; spermatic cord torsion on the ipsilateral testicular fertility function will increase with the age of patients increased, the contralateral testicular impact is still controversial. Conclusion: For patients with symptoms of scrotum should scrutinize the scrotal color Doppler ultrasound screening for patients with confirmed sphincter and patients with scrotum emergency scrotal surgery immediately exploration, according to the specific circumstances to decide whether to perform bilateral testicular fixation, The patient’s reproductive function should be strengthened follow-up.